AI: The Question of Obesity

That’s the message in HBO’s four-part, multidisciplinary documentary “The Weight of the Nation.” Producers Sheila Nevins and John Hoffman pull no punches, shining a light on the multibillion-dollar food and advertising industries, as well as on public officials for not addressing the issue, and for actually making the situation worse.

And they have no shortage of evidence to support their contentions. For example, according to a new report in the Amer­ican Journal of Pre­ven­tive Med­i­cine, if current trends continue, forty-two per­cent of the Amer­ican pop­u­la­tion will be obese by 2030.

Is obesity as big a problem as reported? If so, who should be held responsible for the country’s soaring obesity rates? Food industry? Government officials? Eaters? Which is more of a factor in the obesity trend/epidemic: lacking self-discipline, living in an environment that promotes unhealthy behaviors, video games/Internet? Obesity rates in children have tripled since 1980. How would you reverse this upward trajectory? Would you?

The Afternoon Inquisition (or AI) is a question posed to you, the Skepchick community. Look for it to appear Tuesdays and Thursdays at 3pm ET.

ED (Rebecca): I’ve changed the featured image on this post from one that showed an obese body with the head cropped out to an artist’s satirical image of Ronald McDonald as a breastfeeding mother. Some commenters pointed out that the original image is dehumanizing, and I agree. I’m sorry about the offense caused.

106 Comments

I suspect that weight issues will broadly skew according to the financial wealth of the family. The poorer the family, the less time they have to cook at home, less money to buy better food, less time to join sports and other active pursuits, and less time to monitor children’s consumption.

If we can improve the situation for those families, I would wager that the overall health issues will be reduced in proportion.

Further to this, I remember reading somewhere that the ability to make good choices and use willpower may be linked to stress: people in stressful conditions simply don’t have the necessary neurochemistry to make even simple decisions.

Poverty is a HUGE stressor, and the average person likely sees a lot more commercials for MacDonalds than they do for fresh fruit and veggies.

1. Budget cuts have forced schools to cut out sports and PE. Families that can afford it compensate by sending kids to soccer, karate, etc. The rest have kids with fewer opportunities for exercise. (And perhaps greater homework means less time after school for play).

2. Unhealthy foods are easy and cheap to get. And they’re heavily marketed at kids. (When was the last time you saw a commercial for a banana? A salad?)

It really depends on how we define obesity. The BMI measurement is total caca/junk-science except at the extreme lower & upper ends. Once we figure out what obesity really means, then perhaps we can let individuals (along with their doctors) figure out the best approach to fixing their individual problem.

One problem is simple biology. The body is designed to optimize for “not having enough food”. Its no so good at optimizing for having more. What his means in the most practical sense is that if you gain weight, ever, then diet, your bodies reaction tends to be to go, “Oh, hell, something happened to get me less food, I need to reduce energy use, as much as possible.” This means losing fast muscle, for one. And, *most* exercises are not designed to rebuild muscle to move “fast”. This means that, as you exercise, you never gain back the type of muscle that burns energy quickly, and you end up working almost twice as hard, and eating half as much, to just stay slim, as you would have had to had you never gotten over weight in the first place.

The question of how to fix that, now that we know, isn’t even on the radar yet. It was very recently that this problem was even confirmed.

Kagehi, what you said a) makes no sense and b) is definitely not supported by “basic biology.”

Lisa, you can’t assume that your diet and your friends’ match up exactly, or that you spend exactly the same amount of time performing exactly the same intensity of exercise. Chances are, what you see/hear about their eating and exercise habits doesn’t reflect reality.

I’m sorry, but what!? I am not being condescending, and it does make sense. And it is supported by research. If you lower caloric intake your body reacts like its starving. It tries to compensate for this in a number of different ways. As it turns out ***one*** of those ways is to convert “fast twitch” muscle to “slow twitch”. Why? Because speedy muscles are inefficient. Muscle that provides strength, rather than speed, burns about 25% less energy.

What this means is that if you start out consuming more calories than necessary, your own body reacts to a reduction in those calories by reducing your calorie needs. So, to take off more, or keep it off, you have to work harder than someone that never gained it in the first place.

Its not condescension, its just plain reality. Its not saying the person is lazy, or bad, or unwilling to work at it, or somehow “chose” to be fat. Its simply stating that, once you get there, the majority of methods used to get it off, and keep it off, all fail to recognize a major part of the problem, which is that your body isn’t burning the resources you are putting into it, as quickly as someone whose metabolism never suffered such a drop in calorie intake. The same thing would happen to someone that wasn’t fat, lost a lot of weight, then went back to eating like they did “before” they lost it.

Here is one article on some of the research into the metabolism getting messed up:

I can’t find and online version of the article on fast twitch vs. slow twitch muscle, or the study on that. However, like most studies of the sort, there are about a million idiots that read the study, and are lying about having the “perfect workout” to optimize your weight loss, based on the principle. Its vaguely possible some of them might even partly work, though I would say that the study is so recent, “as of this last year”, that anyone making such a claim is running a scam.

In any case, unless you are seriously looking to label someone as an anti-fat people jerk in this thread, I don’t get how the frak I get to be that person, based on what I posted. I may not be badly over weight, but I could lose some myself, and I kind of like to know *if* **my own body** is working against my efforts to bloody do so. I would think other people would too, because it means that the method you use has to take into account why just going to the gym, and lifting weights, and the like, won’t bloody work, or will leave you working much harder than everyone else around you, just trying to bloody keep up.

And that was, in case you missed who I was replying to, the question, “Why does it seem like I have to work harder than other people around me?” The answer is, our bodies do very well at handling an decline in food, but to very badly at dealing with suddenly having what it previously would have needed, or more than necessary. If this is incorrect, then where is the research saying that, “It doesn’t matter if you cut your calories intake drastically, then go right back to eating a ‘normal diet’ after you lost it.”? Why do all the studies basically say, “For some reason, your body keeps acting like its not going to get enough food, so you have to keep eating less, and working harder, than everyone else around you, to stay even with them.”?

Where am I wrong in any of this? Or did you imagine some sort of “tone” problem? Because, right now, you can imagine any damn tone you want, and given the replies to my reply, you might not be that far off this time.

Sigh.. As much as the threading system here is, kind of interesting, its refusal to allow more than a few levels of nesting, and how “blurry” the edges get when the posts are short (i.e., no clear view of where the nesting actually “is”). Well, sorry. I got a bit confused as to which comments where which. The post was also referencing Alexa, who was making the most directly false statement, by claiming that the body doesn’t have a sort of short circuit with respect to this stuff.

But, I apologize for the parts directed at what I mistakenly attributed to you and others, with respect to where I thought the “indention” was. (This is why most modern IDEs have either highlights showing where you are working, or some sort of “tree” pointing where shit actually connects, or some way to collapse the bits that you are not looking at. Trust web designers to get the idea, “This would be neat!”, but be 10 years behind everyone else that had the same idea. lol)

I don’t know how good your vision or monitor contrast ratio are, but there’s actually a series of rather light gray vertical lines that are meant to show the current nesting level of each post. Each line represents one step down the nesting tree.

Yeah, very light, and the way they point between things, because they are light, makes them really hard to spot. Frankly, I hadn’t even noticed them, they are so light (and that is on a brand new, 1080P, 3D ready, display, with what has got to be pretty good contrast.

Not much of an excuse, but I was probably getting ready for work, and half asleep too. lol

well i work and have gone to school with one of them for years. So I see at least 1 of her meals a day, and sometimes her breakfast if she slept in. She also talks about the stuff she does in general office chit chat. No I don’t observe everything, but from what I’ve seen the difference in my weight and does not correlate to the difference in our eating habits.

At the risk of offending someone again.. Its complicated. Everything from muscle type ratios, to types of exercise, to even the odd, low level, food allergies, which cause quirks in how they are handled, to how specific sugars are metabolized can do strange things. A person can be really unlucky and have a combination those such factors, or they can be very lucky, and have a lot of the opposite. The only thing for certain is that standard dieting, as its been practiced for ages, has problems. Among which is a complete failure to account for most of those other factors. And, the faster the loss, the more likely someone is to trip over one of those factors.

Unfortunately, the majority of the stuff out there is the “old style” dieting, or “lose weight fast” stuff. I.e., the sort of things that fail to account for any of the factors at all. Without knowing what factors are involved, its hard to say. And only someone specializing in working those things out could say.

**However**, right now you don’t have any such experts. What you have is people promoting a “norm”, which may or may not be real (while using BS like BMI, and ignoring evidence that one can be heavy, but healthy), while other people promoting the idea that its not real (while being unhealthy, and ignoring the literal ballooning of the country). I can’t say that either of them are anything but making any sort of solution to the problem, when it *is* a problem, harder. After all, if you assume everyone is a problem, you can hardly collect useful data on what situations are dangerous, and need to be addressed, or why. And, if you deny that any problem exists at all, you undermine any efforts to understand the issues, and the health concerns, or anything else related to the situation.

In the end, its about “if” you have health issues, “if” you will have them later, and what the odds are, and “where” the point is between, “healthy, but big”, and, “you are going to have problems eventually, even if they haven’t shown up yet.” Finding those answers demands that there not be an assumption that anyone over a certain size is in trouble, automatically. But, right now, the biggest problem in trying to figure it out is the people babbling, “I am just big boned!”, while barely able to walk, using electric carts in the grocery store, and saying “yes, have two”, when their kid asks them for a candy bar. And believe me, I have seen these types at my own job.

Simply put, this is an individual’s problem/choice. They are the ones that make the decision what to put in their face – another Hoho or a banana?
All other discussions imply a ruling class (nanny state) that implies that they know better than the ruled class what to do with their bodies & lives.

Except for the fact that people do have to be taught in order to make healthy choices. Religious folks might believe that you can “pull yourself up by your boot-straps” mentally, but that’s really not the case. Brains are machines and they simply can’t do what they don’t know how to do or don’t have enough input to arrive at independently. Sure, I guess you could call that being a nanny state, but that’s reality. In order to live in societies, sometimes societies have to educate us in how to do so.

Also, this ignores current policy that does make it harder for people to eat healthfully. Right now our nanny is feeding us crap and telling us to eat as much of it as we can.

Teaching is different than forcing. It’s one thing to say “don’t eat Hoho, have a banana and go walk around the block” than to have the government come in and ban/tax trans-fats, salty foods, sugary foods, etc.

And yes, our nanny state is partially guilty of the bad eating habits we have (see “food pyramid,” created by the Dept. of Agriculture, which tells you all you need to know)

I’m not sure how much the quality of food has to do with it so much as the amount of food. I know plenty of ‘posh’ people who eat junk food all the time, but they don’t eat as often, lead an active lifestyle, and generally have the luxury of making different choices in many aspects of their lives.
What I don’t want to see is the constant targeting of “where poor people eat and shop”. I find it astounding that their have been popular documentaries about McDonalds and Walmart, but where are the documentaries about Starbucks, Target, Nike, etc. All of which have committed just as many infringements against their employees. But wait, poor people don’t typically shop at those places, so they can’t be all that bad, right?

“What I don’t want to see is the constant targeting of “where poor people eat and shop”.”

Well good for you. If you do just a little bit of Google research you will learn that the supermarket shortage and lack of healthy food choices is a significant problem in many urban and even many rural areas for the (are you ready for this?) POOR. It really sucks to be poor and obesity is strongly correlated with poverty and sometimes choice is what you don’t have when the word is used.

The individual responsibility angle is deeply flawed not because it is “religious” but because it places way too much responsibility on individuals who have too many things competing for their attention and investment of time for investigation. It is bad economics, plain and simple. Individuals only act in their best interest when they can understand the problem. For example, I’ve read articles and seen documentaries on nutrition, glycemic load, satiation, etc. and I barely understand what to do when I walk down the isle in a grocery store or look at a menu (especially one that doesn’t list ingredients or calorie count). And I’m someone with the time, energy, and money to do that research; I don’t work multiple jobs or have kids or have limited education, not everyone is so lucky.

That is why we need the “nanny state”, experts, and peers (all of whom can of course be wrong) to help us out. That’s not elitism, it’s common sense.

Regarding BMI, ya it is a very noisy metric. By no means a golden rule. Some people classified as overweight or obese are perfectly healthy, and could run a marathon far better than I could, while many fit people are similarly classified as underweight. But there is still something significant shown in the increasing trend. It’s a case of don’t throw out the baby with the bathwater.

Well, it’s a simple fact that you can’t get fat unless you take in more food than you need, and that if you eat less than you need, you will lose weight. We lead much more sedentary lifestyles now, but this remains true no matter how sedentary you are.

Now it may be the case that in order to receive adequate nutrition, some people eat large amounts of nutritionally sparse but calorie-dense foods. As someone who pays fairly close attention to the ingredients, cost, and nutritional content of the food I buy, I can say that it’s financially not so difficult to eat adequate nutritious food on a limited budget, without stuffing yourself with calories.

However, there is a certain amount of knowledge and discipline required. The knowledge is not difficult to obtain — good books should be available at any library, and a bit of time with pen and paper can earn you a workable budget — but I suspect that many people aren’t inclined to seek it out, or don’t really know or care that it exists. The discipline may be harder, especially for kids. I have to deny myself tasty things all the time, but I couldn’t do that when I was younger. Parents must be responsible for setting good examples for their children.

Well, it’s a simple fact that you can’t get fat unless you take in more food than you need

Intuitive, but overly simplistic. Obesity is more complex than that, and can result from something other than a cause-effect relationship between an individual and food. Some medical conditions, such as hypothyroidism, some anti-depressants, and diseases like Cushing’s syndrome and others, either contribute to, or cause obesity.

Percentage of people in the US who are overweight or obese: 63.1%
Percentage of people in the US who have hypothyroidism: ~7%
Percentage of people in the US who have Cushing syndrome: ~6%

Why don’t these numbers add up? Because sickness is NOT the primary cause of overweight and obesity. Poor dietary and exercise choices are. The reason for those poor choices can be duked out elsewhere; let’s get the basic facts straight.

Where did anyone say that sickness was the primary cause? They were responding to this obviously false blanket statement:
“Well, it’s a simple fact that you can’t get fat unless you take in more food than you need, and that if you eat less than you need, you will lose weight.”

Your own numbers say that this isn’t ‘simple fact’. There are also a pile of studies pointing toward it being a lot more complicated, and reducing it down to ‘stupid lazy fat people’ is just insulting.

I beg to differ. As someone who had undiagnosed Hashimoto’s and consequently hypothyroidism: it is definitely possible to gain weight without overeating and possible to be unable to lose weight despite starvation like nutrition.

But hey, good on you for more of these fat “facts”. The whole comment section makes me think “these are supposed to be sceptics??”

I know! I’m on the reverse side-I’ve had an eating disorder-but it always shocks me that the people who should be the most compassionate and understand always resort to the “eat less, lose weight. eat more gain, weight” mentality. It’s a load of crap.

I have had an eating disorder, too. Just to clarify the “on the other side” spectrum. I have had bulimia for 7 years with long episodes of “mostly anorexic behaviours” which is what they say when you eat nothing but aren’t underweight enough. God, these categories drive me crazy. It made life in the inpatient eating disorder treatment center this more horrible. Basically I heard “Stop undereating and stop purging but lose weight, goddammit!” all the time.

“I hate Music… but I like to sing”? :) I hope that’s what your name is referring to, because if so, you’re my hero! I do want to say, though, as a fellow Hashimoto, that studies have shown the average weight gain attributable to the disease is 5-10 lbs, mostly water. Here’s a link from a fairly reputable website on thyroid diseases that documents this:

Anecdotal evidence, but in my case, this fit the bill. I am very thin, and I gained about 10 lbs before I was treated with synthroid; most of it did seem to be bloating. After a few months of treatment, I stabilized back to my normal, pre-hypothyroid weight. Hypothyroidism really doesn’t seem to be associated with massive amounts of weight gain, like it is commonly said to be.

I’m sorry to be blunt, but WHERE IS THE SCIENCE? I read sooo many articles about obesity, but no one talks about the recent (albeit controversial) finding that rats, pets, even lab animals with a controlled diet have ballooned up over the past 30 years. Possible reasons cited were:

1. A change in gut bacteria
2. Plastic pollution
3. CO2 (yes, it is reported to make us fat)
4. Lack of sleep

The study was done by David Allison and it is widely ignored in favor of the very simplistic “Americans are eating too much” despite the fact that this has been true for a really long time even before the obesity epidemic.

QUOTE: With colleagues, he scrutinized the weight histories of 24 populations, from alley rats in Baltimore to lab macaques in California and even control groups of mice in federal toxicology studies. In a paper to be published in Proceedings of the Royal Society B (for biology), they report that in 23 of the 24—eight species, 20,000-plus animals—the percentage of obese individuals has risen since the 1940s (or since the oldest records they found). The odds of that happening by chance are 8 million to 1. And since neither feral rats nor lab chimps nor any of the others have cut back on phys ed or patronized vending machines more, says Allison, we need to look for explanations beyond the Big Two.

Did you really need to use a so-called “headless fatty” picture to make this post complete? Say what you will about fat and obesity, but it’s really dehumanizing and fucked up to post someone’s faceless fat torso to get your point across. I would have thought better of this blog.

I have to agree with that. I gained weight when I was very sick, and it stuck with me for years.

I lost 50 lbs over 2 years recently, but I still freak out every time I see one of those anonymous obese people clips on TV or pics online. I’m so afraid I will look up one day and see me. Not nice, fat people have feelings, too. :P

Obesity is interesting in this respect because unlike your examples of poor people and cancer patients, we aren’t afraid to show -their- faces.

There are a lot of reasons for someone to be obese, and it is impossible to know why any individual is overweight simply by looking at them. There is also ample evidence that people who stray from some “ideal” weight or appearance face discrimination and prejudice.

Pointing out an example of privilege or discrimination isn’t living in a rarified world and being unable to “discuss with the grownups”.

Gay people were often filmed as shadows or behind screens with their voices altered when they appeared in media, and I think there may be something similar going on here.

I think whowehavetofear is spot on, and I’m a bit bothered by your dismissal of their complaint. It is reminiscent of mansplaining, frankly. Would you be saying the same thing if it was a headless torso of a thin woman in a bikini on a post about tanning and someone raised the point that your use of the image was objectifying her body? Because you’re objectifying this person’s body here. And instead of recognizing what you’re doing, you’re doubling down.

As somebody who often thinks of Skepchick as one of the few safe places on the interwebs, I’m deeply bothered by your response to criticism about using the cliched headless fat body. Fat shaming is one of the least effective ways to help people become more healthy, and this phenomena is part of that. You are completely dehumanizing these people by removing their faces. You have reduced this person to only their fat body, which is presented as a problem.

I don’t think that it’s asking too much to expect respectful depictions of human beings on this website. Do you really think that fat folks don’t know it’s a mean world? Do you really think further cruelty is going to solve the problem, that maybe we can bully people into doing the “right” thing?

Perhaps whowehavetofear’s expressed incredulity at your using the well-known and oft-decried “headless fatty” cliche image (http://www.charlottecooper.net/docs/fat/headless_fatties.htm) was slightly feigned as a rhetorical means of emphasizing her/his point – I can’t know that.
But my surprise as you, Sam Ogden, for not giving the comment any real thought, and dismissing it blindly, isn’t feigned.
You messed up, being ill-informed about the cliche you accidentally fell into.
The fair response would be to acknowledge your error – and then change the photo.

I think obesity is a social problem. There is a correlation between poverty and obesity, and obesity effects traditional marginalized groups disproportionately: Hispanics, Blacks, Native Americans.

Food deserts do exist, and this creates problems of accessibility to healthy food options, not to mention affordability. $4.06 per day is the amount a single person who qualifies for food stamps receives.

Perhaps the biggest road block in my community to healthy living is time and money. No one seems to have any.

Obesity, while a very big problem in the US, isn’t constrained to the US. Even developing countries like Mexico are seeing it’s effects. Other Industrialized nations are seeing increases too, especially among the poor.

“As I wrote in my book, focusing on obesity is problematic for many reasons. One, it ensures the focus stays on the individual, instead of the food industry. What do you think when you see a fat person? That it’s their fault, they just need to eat better and exercise more. Granted, my public health colleagues are trying to change this conversation to one of the “environment” (far too apolitical a word) but as long as we keep talking about obesity, the framing is all about individual behavior change.

Next, scientific evidence shows that fat people have enough problems dealing with discrimination, bullying, etc, and the last thing they need is more hate brought to you by the federal government and cable television. All the images I have seen coming from news accounts of the conference are negative. Even while the headlines may attempt to reframe from blame and shame, the images do not. For example, this Reuters story headline reads “Obesity fight must shift from personal blame-U.S. panel” but the image is of a fat person. Journalists take note: you are adding to the problem of bias and shame by using these images. (Recently, I wrote an article for the UK Guardian about PepsiCo and they wanted to run it with an image of a fat person. I insisted they change it and thankfully they did.)”

Obesity is a problem in our society, that is really not in doubt. However, it is not something where you can point your finger at individuals, look at the overall system. We have created a marketplace where it is cheaper to subsist on simple sugars and fats instead of complex carbohydrates and protein and fiber. And our diet has objectively declined over time, such as the removal of fiber from our breads.

Ultimately, individual behavior does need to change, but too many are focused on the individual without looking at the toxic environment which surrounds the obesity epidemic.

So many people don’t understand the complexity of endocrinology, and because of their ignorance, participate in discriminatory behavior toward the genetically disabled.

To give y’all a taste of how genes affect obesity and health, I thought I’d paste in a recent Facebook post I wrote in reply to a friend who asked why I wouldn’t convert to vegetarianism.

Why I am Not a Vegetarian

Morally, I want to be. I like animals. I don’t want to eat them. But I am genetically predisposed to physical health problems when partaking of a vegetarian diet. I know, I’ve tried it more than once with disastrous health effects.

I know that vegetarians have good intentions when they ask, “Why aren’t you like me? All it takes is a little willpower.” Unfortunately, they are wrong. I get a little tired of hearing the old, “I have good genes, so why don’t you?” statement (always by a non-biologist), which is no different than someone saying, “I’m white, male and tall, so why aren’t you?” Asking why someone’s biology isn’t exactly like yours is a kind of racism for genetics, I call it “geneticism”.

Sigh. Different people have different genes. And those genes directly affect how their bodies react with the environment.

I have, actually, had my genome sequenced and know for a fact that I have three different gene variants that specifically, when combined with a normal vegetarian diet, and even so called “vegan low carb” diets (which to me are very high in carbs), make me unhealthy, weak, and overweight.

But to educate further, here are some studies that will let people know how different genes can affect people in different ways.

“Obesity originates from a failure of the body-weight control systems, which may be affected by changing environmental influences. Basically, the obesity risk depends on two important mutually-interacting factors: (1) genetic variants (single-nucleotide polymorphisms, haplotypes); (2) exposure to environmental risks (diet, physical activity etc.). Common single-nucleotide polymorphisms at candidate genes for obesity may act as effect modifiers for environmental factors. More than 127 candidate genes for obesity have been reported and there is evidence to support the role of twenty-two genes in at least five different populations.”

“variants in the TUB gene, associatedwith body weight and BMI, were also shown to be associated with eating behavior: carriers of the risk alleles for obesity had a diet high in carbohydrates and low in fats.”

Effects of increased dietary protein-to-carbohydrate ratios in women with polycystic ovary syndrome
“Replacement of carbohydrates with protein in ad libitum diets improves weight loss and improves glucose metabolism by an effect that seems to be independent of the weight loss and, thus, seems to offer an improved dietary treatment of PCOS women.”

“Seven SNPs were associated (P < 0.05) with weight, body mass index (BMI), and waist circumference (unadjusted for BMI). They were in or near to 6 loci: FTO, MC4R, KCTD15, MTCH2, NEGR1, and BDNF. Five SNPs were associated with dietary intake (P < 0.05) and were in or near 5 loci: SH2B1 (particularly with increased fat), KCTD15 (particularly with carbohydrate intake), MTCH2, NEGR1, and BDNF."

The effect of a high-carbohydrate meal on postprandial thermogenesis and sympathetic nervous system activity in boys with a recent onset of obesity

"In conclusion, obese boys possessed normal metabolic and sympathetic responses to the HF meal but showed a diminished thermogenic response to the HC meal, especially during the early phase of obesity."

A glucose-responsive transcription factor that regulates carbohydrate metabolism in the liver

"Here we report the purification and identification of a transcription factor that recognizes the carbohydrate response element (ChRE) within the promoter of the L-type pyruvate kinase (LPK) gene. The DNA-binding activity of this ChRE-binding protein (ChREBP) in rat livers is specifically induced by a high carbohydrate diet…ChREBP is likely critical for the optimal long-term storage of excess carbohydrates as fats, and may contribute to the imbalance between nutrient utilization and storage characteristic of obesity."

"Severely obese subjects with a high prevalence of diabetes or the metabolic syndrome lost more weight during six months on a carbohydrate-restricted diet than on a calorie- and fat-restricted diet, with a relative improvement in insulin sensitivity and triglyceride levels, even after adjustment for the amount of weight lost."

"Women in the CHO Group had higher insulin responses to meals and postprandial hypoglycemia, whereas women in the Protein Group reported greater satiety. This study demonstrates that increasing the proportion of protein to carbohydrate in the diet of adult women has positive effects on body composition, blood lipids, glucose homeostasis and satiety during weight loss."

Sometimes your genes prevent diet and exercise from working altogether!

"A small study of Japanese women measured the effects of a behavioral program for obesity prevention that included changes to diet (reduced calorie intake) and physical activity (walking) in addition to supportive group therapy. Women with two copies of the more common A version of rs4994 (also known as the Trp64Arg variant in the ADRB3 gene) tended to lose weight when they decreased their calorie intake and increased their physical activity, but women with one or two copies of the G version did not experience significant weight loss in response to similar lifestyle changes."

When I lived in Europe for a year I lost a considerable amount of weight without consciously changing my diet or habits. I am still unsure of exactly what it was that precipitated such a huge change, but as I mainly cook for myself and don’t eat many pre-packaged foods, I can only think that there is some kind of subconscious cultural influence at work. Part of it, I think, is a far greater degree of regimentation with regard to meal times and content that has almost entirely been lost in eat-whatever-you-want-whenever-you-feel-like-it North America.

Or the conspiracy theorist in me could always claim it’s because every single thing in the supermarket there wasn’t crammed with corn sugar :p

Well, I wasn’t exactly on vacation, just living in a different place. But yes, certain kinds of stressors can trigger bad habits and/or substance (ab)use.

Speaking of substances, opiates are known to contribute to weight gain and the development of type 2 diabetes, and I find it interesting that the US states with the biggest obesity/diabetes problems also have the highest rates of prescription drug (ab)use. Of course it might just be the sweet tea.

Hi guys. I’m on food stamps. I’m overweight. You’re talking about ME. I should write a whole blog post about this instead of making a comment here, but hey. You asked!

Of course, I only admit to having food stamps because I have a simple reason: I just graduated from college and am as a consequence jobless. Same goes for being overweight–I gained 15 or 20 pounds over 6 months of being extremely stressed. Regardless, let me tell you some things.

Do you know what my first thought was when I got my EBT card a month ago? Go on, guess. It was: AWESOME, now I can afford to buy PRODUCE. I am going to be able to get SO SKINNY NOW! Telling people to eat an apple instead of a Ho Ho (I don’t even know what that is by the way) is incredibly insulting for many reasons, but first of all: Do you know how much a freaking apple costs? They’re like $2 each. They’re EXPENSIVE. Do you know what it’s like to find apples prohibitively expensive? I can eat a week’s worth of bread and butter for the cost of two apples. I’ll leave it up to you to extrapolate the caloric consequences there.

I’m a dancer. I am taking a year or two off before going to graduate school (neuroscience represent!) in order to gain more research experience and to have more time to work on dance. However, here’s the problem: I’m too ashamed by my weight gain to actually go out in public and dance. Why is that? Being fat gives you a poor body image and an intense sense of shame. This shame not only prevents me from doing things I love which would, ironically, solve the problem in the first place but it also leads to intense depression. That depression leads to binge eating, lack of motivation to exercise, even MORE shame about continued weight gain despite wanting nothing more in the world than to be back to my normal weight. Hell, I avoid doing things with my friends because I don’t want them to SEE me.

Do you know what the worst part about all this is? That intense sense of shame and depression was present even when I was a “normal” weight. That is to say I was in my ideal weight range by BMI standards, but I still felt fat and awful and ashamed of myself because I wasn’t meeting society’s expectations for what it was to be thin. I was working out–no exaggeration–30 or 40 hours a week but I felt that I was lazy. LAZY. Why? Because I wasn’t skinny. Because society tells us that if you’re fat you MUST be lazy. By extension, those who aren’t thin (in an unrealistic societal expectation sort of way) are that way because they’re lazy. It didn’t matter how much I was busting my ass–it was never enough. It was soul crushing.

The tl;dr version: Regardless of how one becomes to be overweight/obese in the first place, it is a vicious self-perpetuating cycle. It is INCREDIBLY HARD to lose weight so have some damn respect. Reducing societal shame and increasing social support would probably help. There is a HOST of other physiological factors making it an even more daunting uphill battle: increased hunger drive and ghrelin levels in overweight people who lose weight, for example.

I am so sorry people are such assholes. No one remembers how expensive good food is. Then the loonies talk about how if you’d just eat veg*, it’s so much cheaper and you can buy healthy food!

I lived for four months eating a $2 package of 10 bean burritos a week (I ate a little better on the weekends when my then-boyfriend was paying). That was something like 500 calories a day. And I gained weight 5lbs.

(Edit: By the way, I support you on the “I am actually one of these people, I don’t deserve to be shamed, etc” stuff.)

Wait, seriously? I always go for the cheapest fruit and there is usually a kind of apple or pear that is $1.00 per pound or less (pretty much always less 1.50 per pound), so you’re telling me that you are spending twice as much for one apple as I would spend for a pound of apples. I’m not accusing you of lying but it would kind of be mind blowing to me if there was actually that much variation in food costs. I usually spend 30-40 dollars on food per week, which is less than what I would get if I was on food stamps and got the full amount.

If there IS that much variation, what is going on? Why do other people have to spend so much more on food than me?

It says the average price of apples is 1.07 per pound. So if we assume that the apple weighs say half a pound and you are paying two dollars, you are paying almost 4 times the average cost of an apple, in which case there is SOMETHING wrong going on.

In which case we need, I don’t know, food subsidies? Free public transportation to supermarkets on the weekend? There should be some kind of solution that is at least theoretically possible.

I thought this too, then I remembered I’m in a place where people actually grow a lot of produce and apples. If I lived in say Alaska, or something apples may be expensive. Is there a map of the average price of food?

i once was on a tight budget and tried every store in my area for apples and Whole Foods had the cheapest per pound price (I couldn’t factor in trader joes since they charge per apple); who figured?

I’d recommend growing your own sprouts if you are really hard up for veggies, lentils are cheap and can sprout pretty easy.

OMG, I lived in Alaska and oranges were like $3 each. You are paying for the airplane fuel to haul the produce from the lower 48 states to AK. It’s ridiculous. Most people there who live in rural areas subsistence hunt and fish to feed their families. Also, the native Alaskan population is genetically predisposed to be chubby to keep warm in the cold weather. It is very, very expensive to eat fresh fruit and vegetables. But people manage to be pretty healthy on a diet of fresh seafood and wild meat such as moose, caribou and bear.

Thanks to three of you for your answers. I know about food deserts, but I feel like that’s unusual enough that it shouldn’t be assumed. Like I’ve seen autistic people say that they couldn’t prepare food and couldn’t afford precooked stuff (a less extreme and probably more common version is only being able to microwave food), which basically just leaves them with junk food unless they’re wealthy instead of very poor. But I think they are also very aware that most people are not put into this situation and have access to food they can eat/prepare.

I hadn’t thought about the costs that vary from area in regards to shipping and such, though, and if I lived in that situation my whole life I might begin to take it as assumed. I guess this is where canned fruits come into play, but it can be hard to find cheap canned fruits that aren’t doused in sugar. I’d imagine this would get increasingly harder the further out you get from larger cities and the larger alaskan cities are probably not that impressive by continental standards.

Anyway, the more I think about it the less comfortable I am with someone starting a “Let’s talk about those fat people” topic, especially since there was a post talking critically about the Fat Acceptance movement anyway, which was able to raise many of the same questions here in a more considerate way. I am not a fat acceptance person but I agree with many of their points about discrimination, representation, etc. Approaching things this way must feel very dehumanizing- the experience where your life becomes a curiosity to other people.

Commenters here have done a good job explaining how people’s situations vary, though, and that there are not any quick answers that apply to everyone. I’m not willing to throw out weight as a criteria for health but I would like to see other criteria brought in and taken more seriously than they are now.

They are also starting to try to (you know how these things go when a potential factor is first studied) correlate a lack of sleep with increased body weight, partly based on the theory that people who are awake longer eat more, and partly on the theory that sleep deprivation affects appetite, and other fun stuff like that.

I urge pretty much every commenter who has talked about “facts” and “we all know” to try and think critically about their own assumptions.

I am definitely biased, seeing how I spend the first 22 years of my life, obese, bulimic, undereating, until finally someone believed me and checked if I had an underlying condition that made me gain weight and made it impossible to lose weight.
The fact is: people always treat you like you “just dont know how to eat”, like everyone who is obese is too stupid, too poor, unable to eat fruit and veg. I am a vegan (therefor priviliged enough to go to my supermarket and make the choice to live of rice, beans, tofu, fruit, veg and other things I know are healthy). I know A LOT about nutrtion, more so than 99% people. I am a bit obsessed with nutrition and biochemistry. I have lost 14 pounds in the past months since my hormone levels have finally stabilized thanks to the medicine I get now. I have changed not one thing about my eating habits, but it’s not like people would believe you, of course. Oh yes, they believe me that I am eating healthily and little now, but before? No way, as fat people are always uneducated about nutrition,

YOu can NOT know how a person eats when looking at someone’s body size. And while you can say “hey, this person looks unhealthy”, you might want to remember that obesity/weightgain is a symptom of quite a few diseases, not only a risk factor for others.
I’d also like to point at the study someone else posted in the comments. A fit fat person is A LOT healthier than a non-fit thin person, not just in theory but statistically, too. Fatshaming of course makes it harder to work out and be fit and not buy into your own stigma of being lazy and unable to be active and eat greens.

“But what about (poor) people’s health??”
Well, yes, as I mentioned before, I am very interested in nutrition and I would love for the goverment to change things (though I would also advice against the health scare quacks who proclaim “sugar is like heroin”. Not quite) and most people could change their health a lot by eating better.

BUT

a) this goes for anyone. Skinny, fat and inbetween. And dieting doesn’t help when it comes to malnutrition, frankly.

b) It is also a personal choice if someone wants to eat unhealthily. We shouldn’t and can’t judge them anyone more than anyone who likes to consume alcohol or other drugs. If there is a fat person who loves to eat shittly, we need to stop acting like they’re doing something morally horribly wrong.

c) Yes, poor people do need more financial and educational help but patronizing them is not helpful.

And yes, that picture used here is normalized fatshaming, pure and simple.

I’d like to also point out that the study actually said that fatness *didn’t matter* to health outcomes between ‘fit’ people. Obesity isn’t the problem, lack of fitness is. You can change health outcomes without changing the obesity profile. That’s really good news.

Fit was defined as someone who eats three servings of vegetables a day, goes for a stroll a few times a week, and isn’t an alcoholic or smoker. Walkable communities and throwing vegetables on every burger, burrito, and pizza would help. :D

“I am definitely biased, seeing how I spend the first 22 years of my life, obese, bulimic, undereating, until finally someone believed me and checked if I had an underlying condition that made me gain weight and made it impossible to lose weight.”

When I as in middle school, I gained a bunch of weight seemingly overnight. I found out later it was from a combination of PCOS and Hypothyroidism. I still take medication for both. I was severely bullied because of my weight and developed every eating disorder you’ve probably heard of. :P So, I feel ya.

I have thankfully avoided any eating disorders, but I’ve had my share of unproductive diets. The most successful was a few years ago when under the care of a physician–who was clearly not paying any attention–I undertook a diet which ended up becoming 6 months of 600 calories of protein only a day along with appetite suppressants and supplements and exercise. I lost a whole 30lbs. Three months later I broke my ankle and put every ounce back on in the next two weeks. You heard me right. In two weeks I gained 30lbs. This wasn’t the first time either. Every time I’ve gained weight it has been in 20-30lb increments and occurred within 1-2 weeks. Every time. I topped out at 192lbs.

And then I was diagnosed with PCOS, put on metformin, and lost 20lbs over the course of about a year and a half doing basically nothing. I didn’t diet. I didn’t exercise any more than normal. I didn’t take anything else. I also didn’t abuse myself. If I don’t take my pills for a week because I go on a trip or something and get out of my routine? I put on 10lbs. Within a week of being back on it, it’s back off. Magic. So how is it that I’m eating the same amount as before, exercising the same as before, and yet losing weight instead of gaining it (not even staying steady)? Because it wasn’t my behavior that was making me fat. Now, of course, when my progesterone was (unbelievably) excessively high, yes, I ate more than I would have ordinarily. But it wasn’t sufficient for the weight I gained, and it is inhuman to suggest that someone who is ravenously hungry not eat.

I’m still not at my goal. I have about 25lbs more to go. But guess what I’m not going to do to reach it? Torture myself the way these asshole “personal responsibility” types think I should.

I know that some people just plain eat too much. But I know that plenty of people’s only pleasure in an unimaginably difficult life is tasty, bad food. I also know that stress and want create a weight gain cascade. Given that, I am sure that there is an underlying cause for MANY people. I have known too many people literally starving themselves and still gaining. And doctors don’t bother to look because it is easier to make silent (or not so silent) judgments about them, whine about diet and exercise, and ignore their symptoms. I’m fortunate enough to have found an excellent endocrinologist. She is persistently looking for all the other things that are making me so miserable and unhealthy (my hormones are so hosed) instead of pretending that my joint pain and fatigue and breast pain and headaches are resulting from being a lazy fatty and instead might *just might* result from the pathology demonstrated by my abnormal blood test results. Crazy.

I feel that in the world of political correctness fat people are the last and only group that can be insulted and mocked freely. Fatshaming indeed, as the picture in this post. It seems that overweight is considered as a general reason for all kinds of health problems, even if the actual problem might lie elsewhere.
I find this really annoying and worrying.

Argh, I hate this kind of thinking. Weight is a symptom of a myriad of health issues, not a disease or a condition in and of itself. BMI is generally used to label someone as obese and it’s totally without merit. There’s just no causality there. Nutrition and fitness are causal factors which may or may not show weight as a symptom. This is more big business colluding with government to increase their profits by generating concern for something that doesn’t have a causal relationship with health.

Argh, I hate this kind of thinking. Weight is a symptom of a myriad of health issues, not a disease or a condition in and of itself. BMI is generally used to label someone as obese and it’s totally without merit. There’s just no causality there. Nutrition and fitness are causal factors which may or may not show weight as a symptom. This is more big business colluding with government to increase their profits by generating concern for something that doesn’t have a causal relationship with health except as a possible indicator of another issue.

Better nutrition and fitness is where the focus needs to be. Teaching kids how to cook, choose good foods, and stay fit are vitally important. Unfortunately, the food, drug and weight loss industries and, of course, our legislators tend to fight any real progress there. Just look at the crap that is served in school lunches.

But that isn’t enough. When so many people have to work excessive hours just to stay afloat or keep their jobs, they just don’t have the time to spend to find affordable, nutritious foods and cook them. Until we, as a society, come to value all-around well-being for every individual, instead of the acquisition of money and its trappings, it’s unlikely any health issues that show obesity as a symptom will go away.

I find it strange that we are trying to define such a complex issue as obesity (or rather body image and nutrition as connected to overall health) with single cause answers.

A lot of what has been brought up are relevant points, some others (like air conditioning, television, farm subsidies, fear of child abduction, etc.) are often overlooked, and still others (environmental, genetic, chemical, who knows what all) we don’t yet know.

But what is always overlooked is that, unlike other addictions, if you have an issue with food (and who doesn’t on some level) you can’t just cut it out. Imagine if you had an addiction to alcohol but were told that you still had to consume some alcohol each day but not too much, and that there was no way of knowing beforehand how much would be best, we will just have to figure it out as we go. Do you think that maybe you would have a bit of a “problem” with drinking? Many have that problem with food.

The problems are compounded by a society that judges by what you look like, a personal responsibility streak that thinks that humans can make all decisions that need to be made at all times and should never get help, a government that, on one hand, subsidies and regulates our food in rather arbitrary ways (look up the way milk is priced) and, on the other hand, allows anyone to market using words that seem like they should mean something but mean little to nothing.

And all my ramblings are just the tip of the iceberg.

So, when are we going to get out nutrition pills that we were always promised? Ooh, or better yet replicators that will make everything out of balanced nutrition.

I grew up in America but now live in the UK. Obesity is not as prevalent here as it was in America, but the diets are pretty bad, and it looks like the UK is following in the path of the US.

One thing that appalled me, which made me want to add to this conversation, is at the Olympics this summer in London, 4 McDonalds restaurants are being built in Olympic Park, including the biggest one in the world. It’s this kind of mixed message (fitness vs fast food) that frustrates me. I could go on a total ranty-rant, but I’ll leave that to my brain and yours.

Except, you get the people that are obsessed over every “study” they ever read, as though it was absolute fact too. There was an article in skeptic a while back, which talked about sugars and sugar sustitutes. The gist of it was:

1. Sugar and corn syrup, it doesn’t matter, both break down the same in the body, so if you are taking in a lot, you are making a mistake, either way. (Now, if you listen to the soda industry, people like sweet, therefor it needs to be sweet, therefor corn syrup, since that tastes sweeter. Personally I buy the damn Mexican cokes, where I can get them, because I bloody like the sugar instead, but I guess I am not in their “demographic”).

2. All artificial sweeteners, while there are minor differences, break down into the same things in the blood stream. This includes some level of the most recent boogieman for the nuts, formaldehyde. But, nearly anything you eat produces that, naturally, and drinking a glass of tomato juice, with, or without, sugar added to it, produces more of the stuff that an entire diet soda.

3. The latest craze, Stevia/Truvia, to get it into a granular form, is processed, just like they do sugar, only.. the process they use involved, ding, ding, ding, formaldehyde. (If you really think it “must” be better, buy one of the damn plants, like my brother did, and mash up a leaf, and drop that in your tea, or what ever. But, if you are worried about the dangers of formaldehyde… your pretty much an idiot). Oh, it was also, for almost a year after introduction, illegal to import it. Something about, “No clear evidence that it was actually safe for human consumption.” I.e., hadn’t had the minimum tests the US requires for food products.

Basically, unless you have some stupidly limited diet, like a lab rat, and you eat five pounds of one of them a day, every day, even the “studies” indicating that some of it might, in mega-doses, cause cancer, or the like, don’t hold water. You would have to have a rare genetic fluke, that made this more likely, but… there isn’t a lot of evidence to suggest this is likely. But, people will bend over backwards to avoid some of them, because they are sure it will give them cancer, if they take in like 0.0001% as much as it took to do it to a rat.

For me, I just avoid most of the older ones, if I can, because they taste like crap. lol

Here is a collage of what I think are positive pictures of overweight people. I’m glad they changed the picture from the first one. But why not show some gorgeous plus sized models or a President of the US?

A Fit Fattie here to break it to you that Obesity is not a death sentence.

Look, here’s the deal. I eat well (I can afford for my husband to stay home and do the cooking). Since he was diagnosed with diabetes a few years ago, we cut all HFCS out of our diets. We try to eat more veggies (more of the good veggies, peas are apparently little sugar bombs and corn is just starch). I exercise, I lift weights, I walk, I play dance games on the Wii.

I have numbers that make marathon runners weep. I just got my blood work back a bit ago, and it said (I quote), “excellent cholestrol panel!” Blood sugar is still low normal. Blood pressure, also low normal.

I weigh over 300 lbs.

Most people wouldn’t guess that looking at me, but I am, according to the BMI, DEATHFAT. I should be dropping dead any day now, if you listen to the handwringing.

My current doctor, when I talked to him about the fact that I was NOT willing to diet, that I had been severely eating disordered in my teens and early 20s, said, “You’re healthy, you’re active. Some people are just fat. As long as your numbers are good, don’t worry about it.”

This is the thing that gets me. We can recognize that height is inherited, but if you suggest that fat is? It’s like you just shit on the floor. I come from a long line of fat people, tall fat people on one side, and short fat people on the other. I’m kind of a middling-height fat person. Who knew?

Also, I would like to note that they have shifted the BMI categories for overweight and obese downward twice in the last two decades, so that people who were normal suddenly found themselves overweight or even obese. Might this have something to do with the “skyrocketing numbers” of obesity? You think?

Thanks. I’m one of those sickos who LIKES the gym. I could pick heavy shit up and put it down all day.

My favorite is when people tell me my knees wouldn’t hurt if weren’t fat. Which leads to me having to explain that it was the compulsive over-exercising when I wasn’t fat that wrecked them.

That’s one of the things that gets me about people being jerks to fat people. No one knows why any one person is fat. Anti-depressants, health conditions, or just genetics. We aren’t City of Heroes characters with our stats floating over our heads to tell you why we look like we look. And even if we were, it really isn’t anyone’s business but our own.

People tend to frame “the obesity problem” as if they are really just concerned about health. Which is interesting because there are lots of other unhealthy practices that don’t get as much attention. I’m thinking things like drinking too much, smoking, having a stressful and sedentary job etc… Sure these things get attention, but rarely are they met with the same kind of disgust and tsk-tsking as obesity. I think the reason obesity gets the kind of attention it gets is that people are mostly concerned with how bodies look.

I just heard an NPR program last night that was talking about obesity. The “expert” that was being interviewed was talking about BMI and giving instructions on how to find out your BMI. They discussed all the different levels and what they mean and that it was very important to be in the normal range. No one ever brought up how ineffective BMI is at indicating health of the individual. According to my BMI I’m right on the cusp of obese and overweight. This is because I’m a short woman and I weigh 170lbs. It has no way to account for anything else. I work out 3-4 times a week, walk most of the places I go, and cook about 70% of my meals. I’m healthy and in shape. According to my BMI and the NPR program, I am in an unsafe range and should be worried about my health.

The point that I’m trying to make is that health is a complex thing that is difficult to measure. When you try to frame fat as a health problem, all it really shows is that you want there to be less fat people. If health was really your concern there are better things to focus on.

Equating thin with healthy also has the added problem of discouraging people who don’t get thin when they do “all the right things.” As the study Punchdrunk cited above said, when you have healthy habits you are healthier regardless of weight (unless you fall into either the very, very thin or very, very fat extremes). BUT if we continue telling people that healthy = thin, when they don’t get thin they will frequently give up the healthy behaviors because “they aren’t doing me any good.”

I think we’re confusing image with health. I ran Tough Mudder with some “overweight” people who kicked my ass. I’m sure many obese people are unhealthy, but so are many thin people. Not to mention frame. Did you that know tall women are more prone to breast cancer? How do we separate that from a tall and more weighty frame?

Thanks to people who pointed out sleep, genetics, endocrinology and how it factors into weight. Also read the study I linked to to see how gut bacteria and pollution factor in.

People refuse to believe that fat people who eat vegetables and walk around once in a while are healthy. It’s dehumanizing. Clinging to ignorant prejudice. Nasty, insulting, and mean spirited. Yep, triggering. *hugs if you want ’em*

It’s also counter-productive to keep concentrating on obesity instead of health.

I’m definitely triggered and disturbed not just by the comments, but by the fact that this post exists in the form in which it exists. I’m afraid to comment due to the possibility of retreating back into body-hate depression after reading any possible responses on my views. You are not alone.

I have not seen the HBO work yet but I did hear a long interview with the producer. A few issues:

1 – When asked about the one thing that would effect this problem the most, he stated that he thought getting rid of sugar drinks would help the most. I tend to agree.

2 – When you ask the question about who/what is responsible, I think the issue at the top of the list of things that answer that question is: greed. Companies figure out ways to make products and sell them and most Americans are not well informed about calories or where their food comes from or the vast difference between calories in and calories out and the basic notion of nutrients.

3 – Evolution plays a far larger role than most people understand. We evolved for 100s of 1000s of years to live on seasonally available nutrition. Now people eat all day, all month, all year. Mostly the same stuff. It just doesn’t work.

Bottom line – people need to know where their food comes from, what it is made of and get off their backsides and move. Vigorously. Sweat a bit.

I fired a doctor for that shit. She announced in the middle of the appt. that if I gave up soda, I would lose at least 20 lbs right off the bat. I looked up at her and said, “I don’t drink soda. Once every six months or so I get a wild craving for a Pepsi, I drink half and pour the rest down the drain. How is not drinking that half a Pepsi twice a year going to make me lose weight?”

She then accused me of lying, and went on about how I needed to quit eating fast food (which I don’t eat), and candy and chips (don’t keep either around the house, or eat them more than once a month or so).